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This version of the form is not currently in use and is provided for reference only. Download this version of
Form U-69 (BWC-7573)
for the current year.
Form U-69 (BWC-7573) Contract for Coverage of State Agency or Political Subdivision - Ohio
What Is Form U-69 (BWC-7573)?
This is a legal form that was released by the Ohio Bureau of Workers' Compensation - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form U-69?A: Form U-69 is a contract for coverage of state agency or political subdivision in Ohio.
Q: Who uses Form U-69?A: State agencies and political subdivisions in Ohio use Form U-69.
Q: What is the purpose of Form U-69?A: The purpose of Form U-69 is to establish a contract for insurance coverage for state agencies and political subdivisions in Ohio.
Q: How can I obtain Form U-69?A: You can obtain Form U-69 by contacting the appropriate state agency or political subdivision in Ohio.
Q: Are there any fees associated with Form U-69?A: There may be fees associated with Form U-69. Contact the state agency or political subdivision for more information.
Form Details:
- Released on January 31, 2022;
- The latest edition provided by the Ohio Bureau of Workers' Compensation;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form U-69 (BWC-7573) by clicking the link below or browse more documents and templates provided by the Ohio Bureau of Workers' Compensation.
